Diabetes, Vol 34, Issue 3 306-308, Copyright © 1985 by American Diabetes Association
Prevention of kidney graft diabetic nephropathy by pancreas transplantation in man
SO Bohman, G Tyden, H Wilczek, G Lundgren, G Jaremko, R Gunnarsson, J Ostman and CG Groth
Kidney graft biopsies were performed 2-3 yr after transplantation in eight
type I (insulin-dependent) diabetic patients who had previously been
subjected to kidney transplantation (six patients) or combined kidney and
segmental pancreas transplantation (two patients). In five of the six
patients that had undergone only kidney transplantation, light microscopic
examination of the graft biopsy revealed changes compatible with diabetic
nephropathy, and electron microscopic morphometry showed a thickening of
the glomerular basement membrane (GBM). In the two patients who had been
subjected to combined pancreas and kidney transplantation, the kidney graft
biopsy showed no light microscopic changes suggestive of diabetic
nephropathy, and electron microscopy showed no thickening of the GBM. Thus,
it appears to be possible to prevent the recurrence of diabetic nephropathy
in human kidney allografts by simultaneous pancreas transplantation.